SS Consent to HPV Vaccine - Sedbergh School

I,(Required)

First name Last name

of permanent address(Required)

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

GIVE consent
DO NOT give consent

to my son/daughter/ward to receive the HPV Vaccination.

Child's name(Required)

First Last

Child's date of birth(Required)

Signature of parent or guardian(Required)

Consent(Required)

UK GENERAL DATA PROTECTION REGULATIONS

Our Privacy Notices regarding the collection, safekeeping and use of your data can be found on our website (Privacy Policy - Sedbergh School http://sedberghschool.org/privacy-policy) or by request from the Director of Compliance & Planning, Sedbergh School, Malim Lodge, Sedbergh LA10 5RY. (tr@sedberghschool.org) If you have any concerns about the data we hold or do not wish to receive any further communications from us, don't hesitate to contact the Director of Compliance & Planning.

I agree to the privacy policy.

Quick Links

Consent to HPV Vaccination